Miracle workers who rebuilt Danny's life

On 7 July 2005, Danny Biddle was so badly injured in the Edgware Road Tube bombing that those who worked to save his life didn't believe he would survive. He did - and The Observer arranged a remarkable reunion at St Mary's hospital where he thanked them all

Danny Biddle has run out of words. On 7 July 2005, the 26-year-old building projects manager took the full force of the terrorist bomb which was detonated on a Tube carriage at Edgware Road. Barely recognisable as a human being, he was stretchered into St Mary's Hospital in west London. He is now trying to express his gratitude towards an extraordinary group of people who have painstakingly rebuilt him over the past six months.

Last week Danny returned to the hospital for the first time to meet the staff who contributed towards his fast and, frankly, unexpected recovery. The Observer brought together people from 20 different professions for this meeting and a remarkable photograph. Afterwards they were keen to talk about their memories with their former patient. He couldn't have known some of them because he was unconscious for much of the time he was in hospital, but it was important that he could tell them what they meant to him, and above all show them that he was whole and ready to begin living once more. But the right phrases to express that overwhelming sense of gratitude just wouldn't come.

'Thank you is just two little words,' he said over coffee as they all recalled the terrible events of that July. 'How do those two words begin to express what everyone here did for me, and what they did for all the others, too? I wouldn't be alive if they hadn't given me this extraordinary level of care. I just wish others could see the support I've had.'

As the nurses, therapists and doctors came up to shake his hand, they told him of their involvement. From the first paramedic who found him to the physiotherapist who is now teaching him to walk on prosthetic legs, a chain of care was constructed around Danny. 'I don't consider myself unlucky, you know,' he said. ' My bad luck ended on the day that bomb went off. Everything that's happened to me since then has been very good - and it was my great fortune to end up here.'

This is a story of the NHS in Britain. Not an NHS of closures and funding crises, as we normally hear. Not an NHS of mistaken diagnoses, or cost overruns or hospitals that may never be built. This is a story of the survival of one man and how the health service saved him.

It was well before 8am on 7 July when Danny began his journey to the office. He should never have been on the Circle Line train, but he took it because he was late. It was crowded and he found himself in the front, wedged in among the other commuters. Among them was Mohammad Siddique Khan, who had a rucksack on his back. Khan appeared calm, according to Danny. 'We looked at each other, as you do. He put his hand inside the rucksack. Then he looked away and he pulled back his hand.'

The force of the explosion sent Danny through the doors. He bounced off the wall of the tunnel, and ended up lying on the tracks. As the train came to a halt, the doors broke away from the carriage and landed on him, guillotining his legs. 'I knew my legs had gone,' he said. 'I sat up and I could see the door through them. At that point I resigned myself to dying.'

A fellow passenger, Adrian Heili, from South Africa, lifted the door off his legs. Heili had the good sense to put tourniquets on both legs to try to stem the bleeding. A Tube driver who came down to help, Lee Hunt, was also by his side and talked to him about his life, his beloved Arsenal football club, his girlfriend Lisa Flint - anything just to keep him awake and conscious. Soon, the first medical help was coming towards him.

Graeme Baker, a paramedic with the London Ambulance Service, was one of the first to arrive. 'We just found [Danny] half under the train, half out,' he said. 'I decided to stay with him because of his injuries. I tried to reassure him that help was on the way. Once supplies got down there, I gave him shots of painkillers straight into the arm, and we were able to set up a drip to give fluids.' Baker managed to get him out of the station and into an ambulance, with the help of firemen. 'He was in a fair bit of pain, but he was conscious. He had managed to tell me his name, which I thought was a good sign.'

After the ambulance had pressed its way through the chaotic streets to St Mary's, less than one mile away, Baker went with Danny straight into the casualty department, which had been put on standby 40 minutes earlier. There were five resuscitation teams set up in separate bays, waiting, full of nervous energy, to receive the first patients.

Marcelle Tauber, a senior respiratory nurse who had been sent into the A&E to provide extra help, remembers seeing Danny come in. 'I won't ever forget the sight of this paramedic, covered head to foot in soot and dust, running in with him. The paramedic was sweating profusely, but I thought he was very controlled at the same time, telling us what drugs and fluids he'd given the patient.'

Danny was able to talk at this stage but confused. 'He told me he was an asthmatic, and that lying down wasn't good for him,' Tauber recalled. 'Then he said, "I need to get to work, why can't I go to work?"' Tauber was asked to pick up his left leg to move him. 'I put my hand under it, and to my astonishment it felt like ribbons. The leg was completely shredded.'

After Danny was sedated, he began to deteriorate quickly. His right leg was still attached to the knee, but the foot was turned 180 degrees in the wrong direction. His left eye was very badly damaged, and he had burns across his arms. He had sustained a large cut across the forehead. One eardrum was perforated.

Just minutes after arriving, he had a cardiac arrest and it was the job of Dr Andrew Hartle, a senior anaesthetist in charge of the case, to organise staff to start the heart again. David Toresen, a senior resuscitation officer, said: 'The atmosphere was strangely calm, because everyone knew what they were supposed to do. Calm spreads, in the same way that panic does.'

Toresen started to do chest compressions, to strengthen Danny's heartbeat. Professor Nick Peters, an expert in abnormal heart rhythms, was able to ascertain that it was not an electrical problem with the heart. The heart re-started as they pumped in more fluids and blood, and stabilised him for a while. 'Technically, Danny had died and we brought him back to life,' said Peters.

As soon as Danny had recovered from the arrest, he was sent upstairs for a full CT (computed tomography scan) to see what damage had been done to his head and torso. 'It was a complete shock when he came in, because not one of us had ever seen anyone in this state before,' said Caroline Green, the senior radiographer on duty. The scan itself only took 10 minutes, but moving him was difficult and afterwards it took eight of them to clean away the blood, the soot and the debris from where he had been on the scanner. 'A lot of us cried when we got home that evening,' said Green, 27. 'The enormity of what he had been through - and what others had been through - just sank in. I had no idea whether any human being could survive such injuries.'

At around midday Danny went into theatre, for one of the most remarkable operations to take place within Mary's. Duncan Black, a vascular surgeon whose years of training in South Africa had helped him to understand trauma injuries, was put in charge of the team, but was not sure what they would find. 'Danny had very severe injuries to both lower limbs, as well as to the left eye, his head and his arms,' he said. 'There were secondary burns over the arms and the face. He was losing blood fast - faster than we could replace it.'

Four surgeons simultaneously worked on Danny, along with three theatre sisters, scrub nurses, operating department practitioners, the anaesthetist, and a cardiothoracic registrar. Behind them stood a range of staff who were asked to provide equipment as it was needed. Black could see that neither of Danny's legs was salvageable. 'They were very badly damaged and the flesh had died. If that flesh is not removed, then it can cause contamination and lead to sepsis [blood poisoning].'

Black started work on removing the left leg, which had been destroyed right up to the hip bone. Another surgeon, Ragheed Al Mufti, started to remove his right leg below the knee. As they began to operate, Danny's pulse suddenly disappeared off the screen. He was suffering another major cardiac arrest and the team had only minutes to find what was wrong. Their attempts to restart the heart using external resuscitation and defibrillation failed, so as a last measure they had to try internal cardiac massage, which is where the doctor has to hold the heart and squeeze it until the blood begins to flow through it once more.

Black cut open the chest and a young cardiothoracic registrar, Jo Chikwe, put her hand inside Danny's ribcage and gently squeezed the muscle. Chikwe could feel that it was empty and therefore that no blood was going through it. This could mean only one thing: that although they had the bleeding from the legs under control, he must be losing blood from somewhere else. In order to find the source of bleeding, they had to cut him open down the middle of the torso. General surgeon Dimitri Hadjiminas discovered that Danny's spleen had burst. He removed the spleen and the bleeding was brought under control.

The surgeons then started to carry on with the double amputation and Danny was cleaned up. His burns were treated, and they examined the left eye, which had been badly damaged by pieces of flying debris from the blast. One of the nastiest discoveries they made was that £8 worth of money and a bunch of keys had become embedded into his right leg - these had been in his pocket and were propelled into him by the force of the blast that morning. All of it, apart from one 20p piece which was too deeply embedded to risk, was removed.

The staff emerged from the operating theatre at 4pm. One of the scrub nurses, Natalie Domantaye, said: 'We were physically shattered afterwards and I think we were doubtful he could survive. But we'd done the best we could.' Danny received nearly 70 units of blood, thanks to the team of haematologists who spent much of that day in casualty carrying around a coolbag full of Group O rhesus negative blood, a blood group which can be safely used on any patient. Danny was hanging on to life. Just.

When Danny went into intensive care, he looked like a grotesque cartoon character, his face swollen up to three times its usual size. One of the first to see him was Theresa O'Flaherty, a young Irish nurse who would spend many nights sitting with him by the bed holding his hand. 'We thought he was a 55-year-old man because the explosion had aged him in some way,' she said. 'For the first few days it was taking it hour by hour, seeing if he had the strength to pull through.'

His parents, John and Pauline Biddle, had received a call that morning and made the journey from their home in rural Spain, but it took them a day to get there because there were so few flights. Danny's brother Tony, who works in New York, took the first flight out and made it to the hospital on the afternoon of 7 July. When Danny's girlfriend Lisa arrived, she thought that she might be coming to say goodbye. But her boyfriend was able to open his eyes and say her name, before drifting back into the deep sedative sleep.

They were to spend most of the next 42 days in hospital, taking it in turns to be by Danny's bedside, camping out in a conference room when they needed to be there during the night. Every member of staff is adamant that Danny's family and girlfriend were crucial to his survival. 'They were just there, all the time,' said Gregory de Jong, one of the intensive care nurses. 'You can't quantify it, but it does make a big difference if you have familiar people close to you, around you constantly to reassure you.'

The problems that Danny was to encounter during those days in intensive care were every bit as serious as those needing emergency surgery. On 11 July he developed a condition known as Sirs - sudden inflammatory response syndrome - where the body turns upon itself and produces toxins, as a result of the bruising and the damage done by the blast. This can have a domino effect, and lead in turn to kidney failure.

Not only were the staff trying to deal with this, but it then emerged that he had also picked up an infection as he lay on the rail tracks. A fungus which grows on the walls of the Underground had infected his lungs and could have proved fatal, had microbiologist Dr Annette Jepson and her team not identified it quickly and provided the right anti-fungal medicine to treat it.

Seven days after the first operation, he underwent a second one carried out within the intensive care unit, to remove his damaged left eye. Colin Haylock, a specialist from the Charing Cross Hospital came over, and made a false eye which was able to move around the eye socket. It is such a good match that it is difficult to tell that this it is actually a prosthetic eye.

Danny was to have three further operations at the hospital over the next month to help repair different parts of his body and prevent infections from setting in, but youth and resilience were on his side. Intensive care consultant Dr Simon Ashworth said: 'You could see this willpower coming through as we dealt with one problem after another, but everyone gave a little extra for him. I think people quietly felt that to make Danny better was in a small way an act of defiance against terrorism. After all, nothing else stands so clearly against the ethos of any hospital. '

Once he was no longer sedated, Danny could write messages to them on a board, but still couldn't talk because he had had a tracheostomy - where a hole is made through the throat to the windpipe in order to ensure the airway is safe. Communication wasn't easy, and this was a problem because on most nights, Danny would suffer terrible flashbacks and nightmares of what had happened on the train. He would hear the screams of people who died close to him that day.

'We would tell him where he was, and that he was safe,' said one nurse, Noreen McHale. 'But I remember him writing on his board, "You don't see the things I see when I close my eyes". I didn't know what to reply.'

His father, John, did not believe at first that Danny had the strength to get through the injuries. 'I'm ashamed to admit it now, but I never saw him as very resilient or tough,' he said. 'Maybe I'm a natural pessimist, but I misjudged him badly. I see things in his character that have come out from this, that I didn't think were there. But I think we have all been changed so much by it. I can also see more goodness in human nature, because of all the care and kindness that people have shown to us as a family.' He pauses for a second. 'I hate the man who did this to him, though. I always will.'

As the swellings on Danny's face and arms began to go down, his parents recognised his features once again. He began to resemble the person in the photographs that were pinned up above his bed on the ward. Physically, he was over the worst. But in psychological terms, the biggest hurdles were in front of him.

By the middle of August, Danny was well enough to leave intensive care, and was transferred to Zachary Cope ward. These were his darkest days as he started to come to terms with the scale of his disability. Naj el Mahi, a sister on the ward, recalled that, when he first came in, he wanted to shut out the world. 'Danny asked for all the curtains to be drawn around him. He couldn't bear to see others or to hear others. He was very depressed and withdrawn.'

The nurses' task was to spend time with him, trying to bolster his confidence. There were times when he would wake up screaming "fire, fire", convinced that the people around him were about to be engulfed in flames. On other occasions, he would try to warn the nurses that there was a bomb on the train. El Mahi said: 'Very often, at 3am, one of us would be with him after he had had some terrible dream. We couldn't take the dreams away, but we could be there to reassure him that everything was OK.'

Specialists were brought in to show Danny how to cope without his legs. Occupational therapist Emma Lewis and physiotherapist Bhavin Mehta showed him how to keep his balance when sitting up, and built up the strength in his arms. As his strength came back, staff started to see a difference, and found that he had a sharp sense of humour. One of them said there was always light at the end of the tunnel; Danny replied: 'Don't talk to me about bloody tunnels, I've seen enough of those.'

At the end of September he was transferred to the Douglas Bader unit at Roehampton, south-west London, where amputees are given prosthetic limbs and encouraged to walk again. But the unit does far more than that, giving patients a chance to talk about what they have been through. Danny is aware that it has made a huge difference: 'I have my own room there, so that I can shut myself away if I want to.' But he has had to learn everything from scratch, from how to use the toilet to how to drive a car again.

The man who is now by Danny's side for most of the time is Gareth Roblin, his physiotherapist at Roehampton, who has taught him how to use the new limbs. 'I have to try and build up Danny's confidence so that he does feel able to move the legs. He hasn't fallen over yet,' says Roblin.

Danny has now been able to get new accommodation, a bungalow in Upminister, east London, close to his girlfriend, with full internet access. His employers, TH Kenyon and Co, have been, in his words, 'fantastic' and he will go back to work for them as an estimator.

'It's amazing to know how much people have done,' said Danny, talking to the staff gathered for the photograph. 'I feel I owe it to everyone to walk again. If I just went to bed all day, it would be giving in to the person who did this to me.'

He explained quietly: 'I want to live my life, I don't want to just exist. In 10 years' time, it would be good to look back at it, and to feel that I've really done things. I want to be able to stand up and shake hands with people properly when they come into the room.' Danny Biddle smiles. He knows that without the people around him, he would never have made it this far. Sometimes, just sometimes, he is lost for words.

The saving of a life

7 July Danny Biddle is taken to St Mary's following Edgware Road blast. Suffers two cardiac arrests and undergoes a major operation to save his life.

8 July A further operation is carrried out on the left leg wound. Still critically ill.

12 July Left eye is removed.

15 July Further operation on what remains of his right leg.

22 July Echo cardiogram shows the right side of heart dilated due to a pulmonary embolism, a blood clot on the lungs.